Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date OFFICE USE ONLY <br />To: San Joaquin County JOB # REF # <br />Department of Public Works APN CR # <br />EXP. DATE <br />VALID TO DRIVEWAYS: <br />(Applicant Name) STREET * <br />AREA QUAD * <br />TYPE * <br />(Mailing Address) FORMS <br />NOTES <br />(City, State, Zip Code) <br />(Area Code - Telephone Number) <br />(Email Address) <br />Sketch (Detailed plans may be submitted) <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County highway right-of-way on <br />the ______________ side of ___________________________________ approximately ____________ feet/ mile _________ <br />Work will commence on or after _____________________________________ for approximately ________________________ days. <br />I, the undersigned, certify that I am the owner of the respective property, or am qualified to represent the owner and agree to do the <br />work described above in accordance with the rules and regulations of San Joaquin County and subject to inspection and approval. <br />Signature of Applicant - Title Date <br />Comcast/SEFNCO Communications <br />12687 S Manthey Rd <br />Lathrop, CA 95330 <br />209-319-3104 <br />sysaelee@sefnco.com / adtrevino@sefnco.com <br />See attached. <br />110005 <br />1/29/2024 3/29/2024 <br />Brandt Rd. <br />Lodi <br />Traffic Control Devices <br />SS/WW <br />Special Conditions <br />***No Ground Disturbance*** <br />1/15/2024 <br />South E Brandt Rd 2112 <br />of _ West Locke Rd______________________________________, ____________________, by performing the following work (description of work): <br />1/29/2024 5 <br />1/15/2024 <br />Tie into existing splice case to perform splice. <br />- Permit Coordinator